The use of FAST and ABCD2 scores in posterior circulation, compared with anterior circulation, stroke and transient ischemic attack: Table 1

2011 ◽  
Vol 83 (2) ◽  
pp. 228-229 ◽  
Author(s):  
G Gulli ◽  
H S Markus
Keyword(s):  
Transient Ischemic Attack ◽  
Posterior Circulation ◽  
Anterior Circulation ◽  
Ischemic Attack

Strategy and effect of repeat bypass surgery for anterior/posterior circulation in refractory moyamoya disease

2020 ◽  
Vol 132 (6) ◽  
pp. 1889-1899
Author(s):  
Haruto Uchino ◽  
Daina Kashiwazaki ◽  
Naoki Akioka ◽  
Masaki Koh ◽  
Naoya Kuwayama ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Transient Ischemic Attack ◽  
Bypass Surgery ◽  
Posterior Circulation ◽  
Therapeutic Effects ◽  
Anterior Circulation ◽  
Group A ◽  
Ischemic Attack ◽  
Group B

OBJECTIVEIn this study the authors aimed to describe clinical features, surgical techniques, and long-term outcomes of repeat bypass surgery required for a certain subset of patients with moyamoya disease.METHODSThe authors retrospectively reviewed a total of 22 repeat bypass surgeries for 20 patients (age range 1–69 years) performed during the last 20 years at their institutions. The patients were classified into 2 groups. Group A included 10 patients who underwent repeat bypass surgery for anterior circulation due to insufficient revascularization on the ipsilateral side. Group B included 10 patients who underwent repeat bypass surgery for posterior circulation due to the involvement of the posterior cerebral artery (PCA) after successful initial surgery for anterior circulation.RESULTSPreoperative symptoms included headache in 3 patients, transient ischemic attack in 10, cerebral infarction in 3, and intracranial hemorrhage in 4 patients. Intervals between the initial bypass surgery and repeat bypass surgery were 0.3–30 years (median 3 years). In group A, superficial temporal artery to middle cerebral artery (MCA) anastomosis and indirect bypass were performed on 7 hemispheres. Only indirect bypass was performed on 3 hemispheres because of the lack of suitable donor or recipient arteries. In group B, occipital artery (OA) to PCA anastomosis and indirect bypass were conducted on 4 hemispheres, and OA-MCA anastomosis and indirect bypass on 1 hemisphere. Only indirect bypass was conducted on 7 hemispheres because of the lack of suitable recipient arteries. All 22 repeat bypass surgeries were successfully conducted. During follow-up periods (median 4 years), none of the patients suffered repeat stroke except 1 patient who died of recurrent intracerebral hemorrhage 3 years after repeat bypass surgery for anterior circulation.CONCLUSIONSRepeat bypass surgery was feasible and effective to reduce further incidence of headache attack, transient ischemic attack, and ischemic/hemorrhagic stroke in moyamoya disease patients. Through precise radiological analysis, surgical procedures should be planned to yield maximal therapeutic effects.

Abstract TP174: Nonfocal Symptoms in Patients With Transient Ischemic Attack: The PROMISE-TIA Registry

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Toshiya Ishihara ◽  
Shoichiro Sato ◽  
Toshiyuki Uehara ◽  
Tomoyuki Ohara ◽  
Mikito Hayakawa ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Transient Ischemic Attack ◽  
Posterior Circulation ◽  
Ischemic Heart ◽  
Arterial Stenosis ◽  
Unique Identifier ◽  
Clinical Trial Registration ◽  
Ischemic Attack

Background and purpose: Patients with transient ischemic attack (TIA) occasionally accompany nonfocal symptoms, such as decreased consciousness, confusion, amnesia, and unsteadiness. The purpose of this study was to clarify characteristics and prognosis of TIA patients having nonfocal symptoms, using data of the PROspective Multicenter registry to Identify Subsequent cardiovascular Events after TIA (PROMISE-TIA). Methods: Patients with TIA within 7 days of onset were consecutively enrolled in the Japanese nationwide registry. Factors associated with nonfocal symptoms and 1-year risk of ischemic stroke and ischemic heart disease were assessed in logistic regression and Kaplan-Meier models, respectively. Results: We studied 1348 patients with TIA (871 men, mean age of 69.4±12.4 years). Two hundred and nineteen patients (16%) had nonfocal symptoms. Patients with nonfocal symptoms were more likely to have both diffusion-weighted imaging (DWI)-positive lesions and stenosis/occlusion on vascular examination (magnetic resonance/computed tomographic angiography, or carotid ultrasound) in posterior circulation than those without (11% vs. 4%, p<0.001, 20% vs. 11%, p<0.001), but were otherwise broadly similar with respect to other baseline characteristics. Although 1-year risk of ischemic stroke was not different between the two groups (7.5% vs. 8.2%, p=0.756), the risk of ischemic heart disease was higher in patients with nonfocal symptoms (3.1% vs. 1.2%, p=0.046). Conclusions: Both ischemic changes and arterial stenosis/occlusion in posterior circulation were more frequently observed in TIA patients with nonfocal symptoms and they seem to be at high risk of ischemic heart disease. Clinical Trial Registration: URL: http://www.clinicaltraial.gov . Unique identifier: NCT01581502.

scholarly journals Prediction of Recurrent Stroke or Transient Ischemic Attack After Noncardiogenic Posterior Circulation Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (7) ◽  
pp. 1835-1841 ◽  
Author(s):  
Changqing Zhang ◽  
Yilong Wang ◽  
Xingquan Zhao ◽  
Liping Liu ◽  
ChunXue Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Recurrent Stroke ◽  
Posterior Circulation ◽  
Ischemic Attack

WINGSPAN IN-STENT RESTENOSIS AND THROMBOSIS

Neurosurgery ◽  
2007 ◽  
Vol 61 (3) ◽  
pp. 644-651 ◽  
Author(s):  
◽  
Elad I. Levy ◽  
Aquilla S. Turk ◽  
Felipe C. Albuquerque ◽  
David B. Niemann ◽  
...  
Keyword(s):  
Posterior Circulation ◽  
Anterior Circulation ◽  
Target Vessel Revascularization ◽  
Computed Tomographic ◽  
Stent Restenosis ◽  
Current Series ◽  
Complete Thrombosis ◽  
Ischemic Attack ◽  
In Stent Restenosis

Abstract OBJECTIVE Wingspan (Boston Scientific, Fremont, CA) is a self-expanding stent designed specifically for the treatment of symptomatic intracranial atheromatous disease. The current series reports the observed incidence of in-stent restenosis (ISR) and thrombosis on angiographic follow-up. METHODS A prospective, intent-to-treat registry of patients in whom the Wingspan stent system was used to treat symptomatic intracranial atheromatous disease was maintained at five participating institutions. Clinical and angiographic follow-up results were recorded. ISR was defined as stenosis greater than 50% within or immediately adjacent (within 5 mm) to the implanted stents and absolute luminal loss greater than 20%. RESULTS To date, follow-up imaging (average duration, 5.9 mo; range, 1.5–15.5 mo) is available for 84 lesions treated with the Wingspan stent (78 patients). Follow-up examinations consisted of 65 conventional angiograms, 17 computed tomographic angiograms, and two magnetic resonance angiograms. Of these lesions with follow-up, ISR was documented in 25 and complete thrombosis in four. Two of the 4 patients with stent thrombosis had lengthy lesions requiring more than one stent to bridge the diseased segment. ISR was more frequent (odds ratio, 4.7; 95% confidence intervals, 1.4–15.5) within the anterior circulation (42%) than the posterior circulation (13%). Of the 29 patients with ISR or thrombosis, eight were symptomatic (four with stroke, four with transient ischemic attack) and 15 were retreated. Of the retreatments, four were complicated by clinically silent in-stent dissections, two of which required the placement of a second stent. One was complicated by a postprocedural reperfusion hemorrhage. CONCLUSION The ISR rate with the Wingspan stent is higher in our series than previously reported, occurring in 29.7% of patients. ISR was more frequent within the anterior circulation than the posterior circulation. Although typically asymptomatic (76% of patients in our series), ISR can cause neurological symptoms and may require target vessel revascularization.

scholarly journals Transient Vestibular Symptoms Preceding Posterior Circulation Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Hyun Ah Kim ◽  
Eun Hye Oh ◽  
Seo-Young Choi ◽  
Jae Hwan Choi ◽  
Ji-Yun Park ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Posterior Circulation ◽  
Neurological Symptoms ◽  
University Hospitals ◽  
Limb Weakness ◽  
Multicenter Observational Study ◽  
Posterior Circulation Stroke ◽  
Pattern Frequency ◽  
Vestibular Symptoms ◽  
Ischemic Attack

Background and Purpose: The recognition of clinical features of transient vestibular symptoms (TVSs) preceding posterior circulation stroke (PCOS) would be informative to discriminate dizziness/vertigo due to vertebrobasilar transient ischemic attack from the acute transient vestibular syndrome. We sought to determine the prevalence and characteristics of TVSs preceding PCOS. Methods: We performed a prospective multicenter observational study that had recruited 447 patients with PCOS from referral-based 4 university hospitals in Korea. We investigated the timing, pattern, frequency, duration, and accompanying neurological symptoms of TVSs during the 3 months preceding PCOS. Results: The prevalence of TVSs preceding PCOS was 12% (55/447) during the previous 3 months. The TVSs preceding PCOS occurred within 1 week (33%), between 1 week and 1 month (16%), or between 1 and 3 months (51%). The TVSs were mostly dizziness/vertigo with (36%) or without (60%) imbalance, while the remaining 4% had an isolated imbalance. The dizziness/vertigo was spinning in 38% and was aggravated during head position in 45%. The duration of TVSs was mostly a few seconds (55%) or minutes (38%). Approximately 72% of the patients with PCOS had TVSs 1 to 5 times, while 16% had >10 times. Accompanying neurological symptoms, including headache, tinnitus, limb weakness, sensory change, dysarthria, visual field defect, and diplopia, were reported in 11%. Conclusions: Preceding TVSs can occur in 12% of PCOS during the previous 3 months. Isolated dizziness/vertigo of unknown cause needs to be considered as a vertebrobasilar transient ischemic attack symptom, especially in patients with vascular risk factors. The characteristics of isolated vestibular symptom in vertebrobasilar transient ischemic attacks is highly variable and atypical compared with other transient ischemic symptoms.

Misdiagnosis of lamotrigine toxicity as posterior circulation transient ischemic attack or stroke

2020 ◽  
Vol 111 ◽  
pp. 107284 ◽  
Author(s):  
Patsy Ramey ◽  
Melissa Osborn ◽  
Howard Kirshner ◽  
Bassel Abou-Khalil
Keyword(s):  
Transient Ischemic Attack ◽  
Posterior Circulation ◽  
Ischemic Attack
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